MEDICARE: DR. WILLIAM WALSH D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	MCO2602	NJ

General Provider Information

NPI Number	:	1518952704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM WALSH D.C.

Provider Business Mailing Address
First Line	:	2095 ROUTE 88 E
Second Line	:
City	:	BRICK
State	:	NJ
Zip	:	08724-3265
Country	:	US
Telephone Number	:	732-899-5400
Fax Number	:	732-899-9288

Provider Business Practice Location Address
First Line	:	2095 ROUTE 88 E
Second Line	:
City	:	BRICK
State	:	NJ
Zip	:	08724-3265
Country	:	US
Telephone Number	:	732-899-5400
Fax Number	:	732-899-9288

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	01/24/2018

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